We all have to tolerate uncertainty because we don't know. And, anxious people want to know. And, what we want them to understand is accept that you don't know. It's OK that you don't know. Intolerance of uncertainty or the idea that I don't like not knowing, it's somewhat at the core of a lot of anxiety disorders. I explain it as an allergic reaction. If somebody is experiencing a small bit of uncertainty over something that they fear, it's going to trigger that full anaphylactic intolerance of uncertainty response.
And, when we describe that to patients, I think they really understand that idea and have some empathy for themselves with why they're experiencing such a huge reaction to something that is relatively small. Clients who struggle with anxiety view uncertainty as threatening when, in reality, it's not. But, it's uncomfortable. There is a difference. So, we find that people who have emotional disorders have a vulnerability to negative appraisals. So, what is a cognitive vulnerability? It's the tendency to see things in a more negative way.
So, there's that tendency to overgeneralize and to catastrophize and to have all or none thinking. It's either all good or all bad. I'd say the pervasive theme in GAD, when I work with clients specifically, is to help them embrace their powerlessness. Facing fear means facing uncertainty because no one can guarantee what's going to happen. No matter what we do, no matter what precautions we take, the reality is uncertainty is an unavoidable part of life.
Worrying becomes a way of trying to create certainty in an otherwise uncertain world. The cost of trying to anticipate every single possible negative event is far greater than any possible benefit that might come with occasionally hitting on the right thing. So, once we target intolerance of uncertainty and get it into the spotlight of the cognitive work that we're doing, we can list out, what are all those things you're really itching for answers around? And, where is that anticipatory getting in the way of living your life the way that you want to?
And, what are the ways that we can approach this period of uncertainty or that anticipation of something bad happening in a really explicit way?